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    Type 2 diabetes mellitus and osteoarthritis

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    Author
    Veronese, N.
    Cooper, C.
    Reginster, J.-Y.
    Date
    2019
    Journal
    Seminars in Arthritis and Rheumatism
    Publisher
    W.B. Saunders
    Type
    Article
    
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    See at
    https://dx.doi.org/10.1016/j.semarthrit.2019.01.005
    Abstract
    Objectives: Type 2 diabetes mellitus (T2DM) and osteoarthritis (OA) are common diseases that frequently co-exist, along with overweight/obesity. While the mechanical impact of excess body weight on joints may explain lower limb OA, we sought to explore whether T2DM is linked to OA outside of excess weight and whether T2DM may play a role in OA pathophysiology. The consequence of T2DM on OA outcomes is a question of research interest. Methods: We conducted a critical review of the literature to explore the association between T2DM and OA, whether any association is site-specific for OA, and whether the presence of T2DM impacts on OA outcomes. We also reviewed the literature to assess the safety of anti-OA treatments in patients with T2DM. Results: T2DM has a pathogenic effect on OA through 2 major pathways involving oxidative stress and low-grade chronic inflammation resulting from chronic hyperglycemia and insulin resistance. T2DM is a risk factor for OA progression and has a negative impact on arthroplasty outcomes. Evidence is mounting for safety concerns with some of the most frequently prescribed anti-OA medications, including paracetamol, non-steroidal anti-inflammatory drugs, and corticosteroid injections, while other anti-OA medications may be safely prescribed in OA patients with T2DM, such as glucosamine and intra-articular hyaluronic acid. Conclusions: Future research is needed to better understand whether diabetes control and prevention can modulate OA occurrence and progression. The selection of therapy to treat OA symptoms in patients with T2DM may require careful consideration of the evidence based to avoid untoward safety issues. Copyright 2019 The Authors
    Sponsors
    The meeting was funded by the ESCEO, a Belgian not-for-profit organization. The authors thank the Chair for Biomarkers of Chronic Diseases and the International Scientific Partnership Program (ISPP#0111) at King Saud University, Riyadh, Saudi Arabia for their support.
    Keyword
    Obesity
    Osteoarthritis
    Pathophysiology
    Safety
    Type 2 diabetes mellitus
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85060749938&doi=10.1016%2fj.semarthrit.2019.01.005&partnerID=40&md5=50dc4a99bf958503821644eae70aa81a; http://hdl.handle.net/10713/8711
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.semarthrit.2019.01.005
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